Ask any injured worker about their recovery, and you’ll likely hear the same thing: They can’t wait to get back to their day-to-day. Doctor visits, light duty or even being out of work can weigh on anybody. Add in an injury or illness, and the wait can feel endless.

This wait can be exacerbated if an injured worker’s recovery process is delayed by scheduling, lack of communication, inaccurate treatment plans and more.

Here’s where an independent medical examination comes through in the clutch.

“An Independent Medical Examination (IME) is an impartial review conducted by a qualified physician to assess an injured individual’s medical condition, treatment plan, and any conclusions established by their primary treating doctor. The IME process provides a critical opinion, offering an objective evaluation that ensures clarity and fairness in addressing medical concerns, said Brian Cronk, vice president of National IME Services, CorVel.”

“This ensures that care decisions are evidence-based and align with the best practices in medicine, promoting better outcomes for the individual while offering clarity and confidence to all involved parties, whether it’s the injured worker, their employer, or the insurance provider. Ultimately, the IME is a vital tool in verifying that the injured worker receives the most effective and appropriate care for their specific situation,” he said.

IMEs offer a number of benefits for all parties involved in a claim, from cost savings to more appropriate treatment plans. But they may not be utilized as frequently as they could be. Here’s a deeper dive into what IMEs are, some key areas to review before implementing them, and the potential benefits they could bring to workers’ compensation claims.

What Does an IME Do for Recovery?

Brian Cronk, vice president of National IME Services, CorVel

IMEs are already conducted in all 50 states, each with their own requirements and regulations, and they are not solely used in workers’ compensation — liability and auto insurance lines also use these types of examinations as well.

Looking specifically at the world of workers’ comp, IMEs are used “to address key questions such as whether an injury or condition is causally related to the incident in question. They can evaluate treatment plans, monitor an individual’s recovery progress following surgery, or determine if the individual has reached maximum medical improvement (MMI). IMEs may also assign impairment ratings to quantify the extent of an individual’s disability or limitations,” explained Gretchen Myers, regional manager, CorVel.

Additionally, IMEs can involve assigning impairment ratings to quantify the extent of an individual’s disability or limitations.

This is all to say that IMEs help to keep recovery on track, ensuring that injured parties are receiving appropriate and optimal care, as well as sticking to their plan.

Anyone involved in a case can ask for an IME, from the employer, the insured, right down to the injured person themselves. Often, the request for an IME comes when a party on the claim believes a second opinion is necessary to ensure accuracy or appropriateness of the treatment being provided.

“As a neutral tool, the IME helps reassess the case and, when necessary, adjust the course of action based on the findings of the independent examination,” explained Cronk. “By providing a fresh, unbiased perspective, IMEs support recovery by ensuring that care decisions are evidence-based and aligned with the best path forward.”

How Is the IME Conducted?

Gretchen Myers, regional manager, CorVel

Once the request is made by an involved party to conduct an IME, a physician is selected to conduct an impartial evaluation to clarify an individual’s medical condition, causation and treatment needs.

“A qualified physician, chosen for their expertise and objectivity, conducts the evaluation,” said Cronk. “Before the examination, the physician thoroughly reviews relevant medical records, diagnostic reports and case documentation to understand the individual’s medical history and treatment progress.”

Well-informed questioning by physicians during the IME process translates into a well-informed report and analysis. Once the IME report is finalized, a more accurate plan can be put into play by interested parties on the claim. It acts as an impartial, evidence-based evaluation to ensure informed decisions about the individual’s recovery and claims while supporting fair outcomes.

“The goal is to make certain the report is consistent, reliable and tailored to answer all necessary questions in one comprehensive document, eliminating the need for follow-up inquiries, which can cause delays in the claims process,” Myers added.

An IME Litigation Reminder

Because of the nature of an IME, it’s important for those considering one to also consider the legal aspects surrounding these types of reports.

For example, it’s key that when selecting a physician for the IME assessment, they must have no relationship with the claimant, including other providers within the practice having seen the claimant before.

“At CorVel, we go a step further by ensuring the selected doctor has no prior connection to the employer—such as having a spouse employed there or previously being on staff. These measures help eliminate potential bias, as attorneys scrutinize such factors to maintain the integrity and impartiality of the IME process,” said Myers.

Injured workers should be treated with respect, regardless of whether an IME is introduced into a claim or not. However, in the instances when IMEs are introduced, it’s key that their treatment and emotions are taken into consideration and with fairness.

“The report aims to comprehensively address all pertinent medical records and provide thorough answers to all questions. Ensuring fairness and minimizing disputes are essential to the overall IME process and outcome,” said Myers.

“When all parties feel the process is fair and their concerns are addressed, it can help with potential litigation and reduce related expenses.”

3 IME Benefits to Consider

1) Faster Scheduling and a Speedier Recovery

IMEs, by nature, can get injured workers seen by providers sooner, because physicians’ offices understand the underlying urgency of these types of requests.

Per Myers, “They recognize that an individual patient might be awaiting surgery or may need to return to work promptly. This understanding often leads to expedited appointments.”

Faster scheduling also means injured workers have access to an accurate treatment plan sooner, further benefiting the claim down the line.

“Now the claim is moving more efficiently, getting the individual seen sooner,” Cronk said. “This streamlines the scheduling process, which positively impacts the overall trajectory and resolution of the claim.”

2) Finding Resolution for Workers’ Comp Claims

Getting injured workers on the right path to recovery means getting them the right treatment plan from the start. Should an injured worker be on the wrong path, claims resolution can be delayed.

That can also leave injured workers feeling stressed and disheartened, especially if they were following an inaccurate plan.

“An IME can expedite a claim’s resolution by providing an unbiased, second opinion from a physician who is independent of the primary treating physician and any other providers involved in the case,” Myers said.

“By examining all angles and ensuring the injured worker has access to the necessary options, it demonstrates a commitment to their wellbeing,” Cronk added. “This comprehensive approach helps foster trust among all parties in the claim, leading to a commitment to recovery, and by extension, resolution.”

A fresh perspective can ensure the injured worker is receiving the correct treatment and guide the case towards an appropriate endpoint more efficiently. It’s important to note, however, that an IME is not designed to close a claim or bring about faster scheduling. Instead, it plays a key role in aligning care with the worker’s medical needs and recovery goals. By confirming the right treatment plan and ensuring their recovery is on track, an IME supports a faster and more informed resolution process.

3) Early Assessment Can Lead to Cost Savings

Perhaps the most significant benefit an IME offers is its potential for cost savings. When conducted early, the IME can identify inappropriate treatment plans before they unintentionally send injured workers down the wrong path of recovery.

This, in turn, prevents payments for unnecessary treatments and provides workers with appropriate care sooner, accelerating the claim resolution process.

This impartial assessment not only helps contain costs but also provides the injured workers with a clearer understanding of their treatment plans, Cronk said. “When workers feel confident and comfortable with the direction of their care, it fosters trust in the process and encourages a smoother path to resolution.”

Above All, IMEs Mean Communication

No one wants to be left in the dark when it comes to injury recovery. Isolation breeds contempt. But good, clear, concise communication can lead to better outcomes.

IMEs provide open and honest communication. Any potential concerns or doubts about recovery are addressed through an IME report, as all medically relevant information is gathered and assessed.

“Removing potential disagreements or uncertainties about the initial examination findings is crucial for ensuring a smooth and efficient process,” said Myers. “By proactively addressing any doubts or concerns, it helps to build confidence and alignment among all parties involved.”

“By offering insights from a highly qualified and objective source, IMEs play a crucial role in ensuring that injured individuals receive the most effective care for their specific needs,” added Cronk. “With the guidance provided by IMEs, patients can feel more confident that they are on the best possible track to regain their health and return to work.” &